A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone
Central nervous system (CNS) involvement in multiple myeloma (MM) (MM-CNS) in the form of leptomeningeal myelomatosis or brain parenchyma plasmacytoma is rare, causing challenges in clinical diagnosis and treatment. We would like to report a case of leptomeningeal myelomatosis and illustrated the ch...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2022/4081971 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562170444906496 |
|---|---|
| author | Jew Win Kuan Sing Ling Chai Pathmanathan Rajadurai Lee Gong Lau Joseph Uchang Sharifah Noor Akmal Syed Husain |
| author_facet | Jew Win Kuan Sing Ling Chai Pathmanathan Rajadurai Lee Gong Lau Joseph Uchang Sharifah Noor Akmal Syed Husain |
| author_sort | Jew Win Kuan |
| collection | DOAJ |
| description | Central nervous system (CNS) involvement in multiple myeloma (MM) (MM-CNS) in the form of leptomeningeal myelomatosis or brain parenchyma plasmacytoma is rare, causing challenges in clinical diagnosis and treatment. We would like to report a case of leptomeningeal myelomatosis and illustrated the challeges. A 61-year-old man was diagnosed with MM with left paravertebral plasmacytoma, R-ISS II with high suspicion of double-hit MM, either biallelic aberrancy of TP53 or del(17p) and IGH aberrancy depending on the definition chosen, treated with lenalidomide-bortezomib-dexamethasone and local radiotherapy, later developed systemic relapse and progression to MM-CNS in the form of leptomeningeal myelomatosis. A modified CNS-based treatment not reported before, consisting of daratumumab, pomalidomide, vincristine, procarbazine, and dexamethasone, brought a rapid clinical improvement and warrants a further study. Incorporation of intrathecal thiotepa into the regimen would likely increase the efficacy. |
| format | Article |
| id | doaj-art-234562dfe5c9459d9d7f3e76df51909a |
| institution | Kabale University |
| issn | 2090-6579 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-234562dfe5c9459d9d7f3e76df51909a2025-02-03T01:23:11ZengWileyCase Reports in Hematology2090-65792022-01-01202210.1155/2022/4081971A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and DexamethasoneJew Win Kuan0Sing Ling Chai1Pathmanathan Rajadurai2Lee Gong Lau3Joseph Uchang4Sharifah Noor Akmal Syed Husain5Department of MedicineTimberland Medical CentreSubang Jaya Medical CentreBorneo Medical CentreBorneo Medical CentrePantai Premier Pathology Sdn BhdCentral nervous system (CNS) involvement in multiple myeloma (MM) (MM-CNS) in the form of leptomeningeal myelomatosis or brain parenchyma plasmacytoma is rare, causing challenges in clinical diagnosis and treatment. We would like to report a case of leptomeningeal myelomatosis and illustrated the challeges. A 61-year-old man was diagnosed with MM with left paravertebral plasmacytoma, R-ISS II with high suspicion of double-hit MM, either biallelic aberrancy of TP53 or del(17p) and IGH aberrancy depending on the definition chosen, treated with lenalidomide-bortezomib-dexamethasone and local radiotherapy, later developed systemic relapse and progression to MM-CNS in the form of leptomeningeal myelomatosis. A modified CNS-based treatment not reported before, consisting of daratumumab, pomalidomide, vincristine, procarbazine, and dexamethasone, brought a rapid clinical improvement and warrants a further study. Incorporation of intrathecal thiotepa into the regimen would likely increase the efficacy.http://dx.doi.org/10.1155/2022/4081971 |
| spellingShingle | Jew Win Kuan Sing Ling Chai Pathmanathan Rajadurai Lee Gong Lau Joseph Uchang Sharifah Noor Akmal Syed Husain A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone Case Reports in Hematology |
| title | A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone |
| title_full | A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone |
| title_fullStr | A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone |
| title_full_unstemmed | A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone |
| title_short | A Case Report of Leptomeningeal Myelomatosis and Rapid Improvement with Regimen Consisting of Daratumumab, Pomalidomide, Vincristine, Procarbazine, and Dexamethasone |
| title_sort | case report of leptomeningeal myelomatosis and rapid improvement with regimen consisting of daratumumab pomalidomide vincristine procarbazine and dexamethasone |
| url | http://dx.doi.org/10.1155/2022/4081971 |
| work_keys_str_mv | AT jewwinkuan acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT singlingchai acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT pathmanathanrajadurai acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT leegonglau acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT josephuchang acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT sharifahnoorakmalsyedhusain acasereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT jewwinkuan casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT singlingchai casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT pathmanathanrajadurai casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT leegonglau casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT josephuchang casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone AT sharifahnoorakmalsyedhusain casereportofleptomeningealmyelomatosisandrapidimprovementwithregimenconsistingofdaratumumabpomalidomidevincristineprocarbazineanddexamethasone |